Previous blogs have explained how hospice can help provide end of life care in which the main focus is quality of life. Hospice allows for dignity and comfort by having treatment focus on relief from the symptoms and stress of serious illness – whats known as palliative care. A recent article in The Wall Street Journal however describes some disturbing trends which has resulted in a significant increase in hospice care spending.
As stated in the February 19 article titled “Hospice Bills Sting Medicare”, Medicare hospice spending has roughly doubled over the last nine years. This is due largely to the expansion of hospice treatment from those with terminal cancer – the programs original focus – to patients with other ailments including dementia whose death may take years rather than months. In many ways this is a good thing. Those suffering and struggling with dementia certainly deserve the same opportunity to die with dignity as someone who has cancer or other illness.
However, another factor in the expansion of hospice care is due to its billing structure which pays hospice agencies for each day a beneficiary is enrolled, regardless of whether services are actually provided. Since dementia patients are often are stable and thus do not require a high level of care, this can be financially very beneficial to hospice agencies. Also, as you might expect, there has been abuses of the program by some agencies that have enrolled patients in the program even though they were not likely to die within six months.
The hospice program has been around for over 30 years and has provided a necessary and important service for those with a terminal illness. It is critical that the program be protected so the next generation can have the same option.